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Thayne Edward Vickstrom
Pharmacist in Corvallis, Oregon
NPI 1265705768

Thayne Edward Vickstrom is a Pharmacist based in Corvallis, OR. Thayne Edward Vickstrom practices in Corvallis, OR. The NPI Number for Thayne Edward Vickstrom is 1265705768 and holds a License No. 9544 (Oregon).

The current practice location address for Thayne Edward Vickstrom is 1555 Sw 53Rd St, Corvallis, OR and can be reached out via phone at 541-758-3392 and via fax at 541-758-4159.

Location: 1555 Sw 53Rd St, Corvallis, OR, 97333-2630
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1265705768
Provider Name
Thayne Edward Vickstrom
Credential
Provider Entity Type
Individual
Gender
Male
Address
1555 Sw 53Rd St, Corvallis, OR, 97333-2630
Phone Number
541-758-3392
Fax Number
541-758-4159
Provider Enumeration Date
02/14/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
9544 01 OR STATE PHARMACIST LICENSE
institution
Provider Business Practice Location Address Details
Address
1555 Sw 53Rd St
City
Corvallis
State
Oregon
Zip
97333-2630
Phone Number
541-758-3392
Fax Number
541-758-4159
person
Provider Business Mailing Address Details
Address
1555 Sw 53Rd St
City
Corvallis
State
Oregon
Zip
97333-2630
Phone Number
541-758-3392
Fax Number
541-758-4159
person
Provider's Taxonomy Details 1
Type
Pharmacy Service Providers
Classification
Pharmacist
Speciality
-
Taxonomy
183500000X
License No.
9544 (Oregon)
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
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